STONESPRINGS HOSPITAL CENTER
24440 Stone Springs Boulevard, Dulles, VA · HCA Virginia · · NPI 1972904738
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| CT colonography screening CPT 74263 | not published | not published | $1,486.98 – $1,486.98 | 1 |
| CT guidance for needle placement CPT 77012 | not published | not published | $224.26 – $898.33 | 2 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $6,345.32 | $6,345.32 | $208.78 – $833.63 | 2 |
| CT guid parench tis ablat CPT 77013 | not published | not published | $677.70 – $677.70 | 1 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $1,542.18 | $1,542.18 | $102.80 – $219.57 | 3 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | not published | not published | $401.74 – $2,862.18 | 3 |
| CT hrt w/3d image CPT 75572 | $1,696.33 | $1,696.33 | $309.08 – $1,574.02 | 3 |
| CT limited or localized follow-up study CPT 76380 | $2,641.02 | $2,641.02 | $171.42 – $850.79 | 3 |
| CT lower extremity w/contrast (both sides) CPT 73701 | not published | not published | $205.30 – $1,331.37 | 3 |
| CT lower extremity without contrast (both sides) CPT 73700 | not published | not published | $178.39 – $1,142.05 | 3 |
| Ctlso a-p-l control molded HCPCS L0700 | not published | not published | $1,761.86 – $2,513.58 | 12 |
| Ctlso a-p-l control with inter HCPCS L0710 | not published | not published | $1,799.95 – $2,567.94 | 12 |
| Ctlso axilla sling HCPCS L1010 | not published | not published | $57.84 – $82.52 | 12 |
| Ctlso milwauke initial model HCPCS L1000 | not published | not published | $1,767.67 – $2,521.87 | 12 |
| CT lwr extremity w/o&w/dye CPT 73702 | $7,585.21 | $7,585.21 | $214.31 – $1,620.25 | 3 |
| CT neck soft tissue w/contrast CPT 70491 | $4,549.48 | $4,549.48 | $244.21 – $1,333.29 | 3 |
| CT neck soft tissue without contrast CPT 70490 | $3,460.00 | $3,460.00 | $227.36 – $1,140.75 | 3 |
| CT neck soft tissue without & w/contrast CPT 70492 | $5,559.94 | $5,559.94 | $284.03 – $1,604.81 | 3 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | not published | not published | $223.39 – $1,606.54 | 3 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $4,336.59 | $4,336.59 | $200.11 – $1,333.29 | 3 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $3,413.61 | $3,413.61 | $227.36 – $1,140.75 | 3 |
| CT scan for localization CPT 77011 | not published | not published | $231.87 – $3,115.39 | 2 |
| CT scan for therapy guide CPT 77014 | not published | not published | $840.08 – $840.08 | 1 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $10,434.61 | $10,434.61 | $356.77 – $4,903.60 | 3 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $8,828.07 | $8,828.07 | $322.07 – $4,380.44 | 3 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $7,772.27 | $7,772.27 | $307.08 – $3,205.79 | 3 |
| CT thoracic spine w/contrast CPT 72129 | not published | not published | $215.67 – $1,557.39 | 3 |
| CT thoracic spine without contrast CPT 72128 | $6,014.58 | $6,014.58 | $178.39 – $1,331.37 | 3 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $442.48 | $442.48 | $182.03 – $310.66 | 3 |
| CT t-spine w /wo contrast CPT 72130 | $7,023.34 | $7,023.34 | $224.75 – $1,893.58 | 3 |
| CT upper extremity w/contrast (both sides) CPT 73201 | not published | not published | $205.30 – $1,331.37 | 3 |
| CT upper extremity without contrast (both sides) CPT 73200 | not published | not published | $178.39 – $1,142.05 | 3 |
| CT uppr extremity w/o&w/dye CPT 73202 | not published | not published | $214.31 – $1,621.59 | 3 |
| Cuffs adj lock with active con HCPCS L3740 | not published | not published | $901.34 – $1,285.90 | 12 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $125.79 – $725.66 | 3 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $130.83 – $725.66 | 3 |
| Culture aerobic additional method definitive id each CPT 87077 | $130.58 | $130.58 | $6.20 – $45.84 | 15 |
| Culture afb any source CPT 87116 | $735.18 | $735.18 | $8.29 – $41.12 | 15 |
| Culture anaerobic additional method definitive id each CPT 87076 | $205.41 | $205.41 | $6.20 – $45.84 | 15 |
| Culture anaerobic except blood CPT 87075 | $868.37 | $868.37 | $7.27 – $53.67 | 15 |
| Culture bacteria anaerobic CPT 87073 | not published | not published | $7.42 – $53.51 | 15 |
| Culture bacterial urine HCPCS P7001 | not published | not published | $18.84 – $91.66 | 2 |
| Culture bact stool aero addl path ea CPT 87046 | not published | not published | $7.25 – $53.51 | 15 |
| Culture body fluid CPT 87070 | not published | not published | $6.62 – $48.84 | 15 |
| Culture fungi definitive id mold CPT 87107 | $234.59 | $234.59 | $7.93 – $58.55 | 15 |
| Culture fungi definitive id yeast CPT 87106 | $234.59 | $234.59 | $7.93 – $58.55 | 15 |
| Culture fungi other (except blood) CPT 87102 | $735.03 | $735.03 | $6.46 – $47.66 | 15 |
| Culture fungi skin/hair/nail CPT 87101 | $735.18 | $735.18 | $5.92 – $43.73 | 15 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $176.22 | $176.22 | $11.22 – $62.08 | 15 |
| Culture mycoplasma any source CPT 87109 | not published | not published | $11.82 – $87.29 | 15 |
| Culture of specimen by kit CPT 87084 | not published | not published | $20.78 – $103.07 | 15 |
| Culture quantitative aerobic other source CPT 87071 | $668.52 | $668.52 | $7.60 – $53.51 | 15 |
| Culture screening strep group a CPT 87081 | not published | not published | $5.09 – $37.60 | 15 |
| Culture type pulse field gel CPT 87152 | not published | not published | $5.94 – $29.68 | 15 |
| Culture typing added method CPT 87158 | not published | not published | $5.94 – $29.68 | 15 |
| Culture typing glc/hplc CPT 87143 | not published | not published | $9.62 – $71.09 | 15 |
| Culture typing immunologic CPT 87147 | $170.24 | $170.24 | $3.97 – $29.35 | 15 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | not published | not published | $167.44 – $885.32 | 15 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | not published | not published | $26.95 – $201.82 | 15 |
| Culture urine each isolate CPT 87088 | not published | not published | $6.21 – $45.92 | 15 |
| Culture virus isolation CPT 87250 | not published | not published | $15.02 – $110.92 | 15 |
| Cus elbo skt in for con/atyp HCPCS L6696 | not published | not published | $1,185.68 – $1,691.56 | 12 |
| Cus elbo skt in not con/atyp HCPCS L6697 | not published | not published | $1,185.68 – $1,691.56 | 12 |
| Custom glove for term device HCPCS L6895 | not published | not published | $568.41 – $810.93 | 12 |
| Custom shape cover ak HCPCS L5705 | not published | not published | $988.85 – $1,410.75 | 12 |
| Custom shape cover bk HCPCS L5704 | not published | not published | $539.35 – $769.47 | 12 |
| Custom shape cvr hip disart HCPCS L5707 | not published | not published | $1,295.78 – $1,848.65 | 12 |
| Custom shape cvr knee disart HCPCS L5706 | not published | not published | $964.49 – $1,376.01 | 12 |
| Cv stress test i&r only 93018 CPT 93018 | not published | not published | $61.45 – $61.45 | 1 |
| Cv stress test/supervision only 93016 CPT 93016 | not published | not published | $95.71 – $95.71 | 1 |
| Cyanocobalamin unsat binding capacity CPT 82608 | not published | not published | $11.00 – $81.24 | 15 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $73.79 | $73.79 | $0.50 – $1.70 | 5 |
| Cyclic citrullinated peptide antibody CPT 86200 | $635.28 | $635.28 | $9.95 – $74.46 | 15 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | not published | not published | $0.60 – $1.56 | 5 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | not published | not published | $0.85 – $4.82 | 5 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | not published | not published | $53.55 – $195.25 | 5 |
| Cyclosporine 2 hour CPT 80158 | $945.82 | $945.82 | $13.86 – $102.43 | 15 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | not published | not published | $0.55 – $1.40 | 5 |
| Cyclosporine oral 100 mg HCPCS J7502 | not published | not published | $1.52 – $4.80 | 5 |
| Cygnus matrix, per sq cm HCPCS Q4199 | not published | not published | $202.75 – $336.92 | 4 |
| Cygnus, per sq cm HCPCS Q4170 | not published | not published | $64.68 – $444.74 | 4 |
| Cyp2c19 gene com variants CPT 81225 | not published | not published | $291.36 – $1,109.09 | 14 |
| Cyp2c9 gene com variants CPT 81227 | not published | not published | $174.81 – $665.45 | 14 |
| Cyp2d6 gene com variants CPT 81226 | not published | not published | $450.91 – $1,716.46 | 14 |
| Cyp3a4 gene common variants CPT 81230 | not published | not published | $174.81 – $665.45 | 13 |
| Cyp3a5 gene common variants CPT 81231 | not published | not published | $174.81 – $665.45 | 13 |
| Cystatin c CPT 82610 | $441.72 | $441.72 | $14.22 – $78.15 | 15 |
| Cystic fibrosis cftr CPT 81223 | not published | not published | $499.00 – $5,871.00 | 15 |
| Cystine urine quantitative CPT 82131 | not published | not published | $17.65 – $95.69 | 15 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $2,388.47 | $2,388.47 | $57.76 – $828.27 | 4 |
| Cystometrogram w/up 51727 CPT 51727 | not published | not published | $1,045.40 – $1,045.40 | 1 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | not published | not published | $0.61 – $2.23 | 5 |
| Cytarabine liposome inj HCPCS J9098 | not published | not published | $571.82 – $571.82 | 1 |
| Cytog alys chrml abnr lw-ps CPT 81349 | not published | not published | $919.84 – $4,415.73 | 14 |
| Cytogenetics 25-99 CPT 88274 | not published | not published | $32.54 – $197.44 | 15 |
| Cytogenetics 3-5 CPT 88272 | not published | not published | $31.25 – $154.95 | 15 |
| Cytogenomic neo microra alys CPT 81277 | not published | not published | $1,160.00 – $4,415.73 | 13 |
| Cytogenom microarray copy nmbr var CPT 81228 | not published | not published | $900.00 – $3,425.99 | 14 |
| Cytog genom-wid alys hem mal CPT 81195 | not published | not published | $1,263.53 – $1,993.65 | 10 |
| Cytomegalovirus ag ia CPT 87332 | not published | not published | $9.20 – $62.48 | 15 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.